LONG-TERM RISK-FACTORS FOR BLEEDING AFTER 1ST COURSE OF ENDOSCOPIC INJECTION SCLEROTHERAPY - A UNIVARIATE AND MULTIVARIATE-ANALYSIS

The purpose of this study was to define the risk factors linked to the rupture of esophageal varices following endoscopic injection scleroth erapy. A total of 197 patients with esophageal varices who had been tr eated by endoscopic injection sclerotherapy between 1985 and 1991 were observed for post-therapeutic bleeding from esophageal varices. Among 197 patients, 96 had esophageal varices and concomitant hepatocellula r carcinoma. Analysis by the multivariate Cox's proportional hazard mo del disclosed that incomplete eradication of esophageal varices, the p resence of hepatocellular carcinoma, and Child-Pugh classes were stati stically significant predictors for rupture of esophageal varices afte r sclerotherapy. We conclude that complete eradication of esophageal v arices is essential for sustained effectiveness of endoscopic injectio n sclerotherapy. The presence of hepatocellular carcinoma and a lack o f hepatic functional reserve, as indicated by Child's classification, are also major determinants of post-therapeutic bleeding.